Stem Cell Transplant, CAR-T Combo May Improve Lymphoma Survival

M. Alexander Otto, PA, MMS

August 26, 2022

The study was published on researchsquare.com as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Combining autologous stem cell transplantation with anti-CD30 chimeric antigen receptor T-cell therapy is a highly effective treatment for relapsed/refractory CD30+ lymphoma, even for patients with PET-positive and chemorefractory disease.

Why This Matters

  • Long-term outcomes are poor when patients with relapsed/refractory lymphoma do not have a complete response to chemotherapy before stem cell transplant.

  • In clinical trials of anti-CD30 CAR T-cells in relapsed/refractory disease, the overall response rates are 53% to 78%, and the median progression-free survival is just 6 months.

  • The current study suggests that combining the two approaches may have a powerful synergist effect, improving survival outcomes over either option alone.

Study Design

  • Five patients with classical Hodgkin lymphoma and one with ALK-negative anaplastic large-cell lymphoma received CD34-positive hematopoietic stem cells after myeloablative chemotherapy as well as an anti-CD30 CAR-T therapy.

  • Three patients had experienced relapse at least twice, and three had primary refractory disease.

  • For all patients, PET imaging was positive before transplant (Deauville 4–5).

Key Results

  • Engraftment was successful in all cases.

  • The objective response rate was 100%, including five complete responses and one partial response.

  • At a median follow-up of 20.4 months, all six patients were alive and were maintaining their response.

  • Five patients developed cytokine release syndrome, all of grade 1.

  • No neurotoxicity was observed.

Limitations

  • The study was a small, single-institution investigation.

  • Only one patient received the CD30-directed antibody-drug conjugate brentuximab vedotin, which was approved in China after the study started.

Disclosures

  • The work was funded by the National Natural Science Foundation of China and others.

  • Three authors are employees of Wuhan Bio-Raid Biotechnology.

This is a summary of a preprint research study, "Autologous Stem Cell Transplantation in Tandem With Anti-CD30 CAR T-Cell Infusion in Relapsed/Refractory CD30 + Lymphoma," led by Peiling Zhang of the Huazhong University of Science and Technology, China. The study has not been peer reviewed. The full text can be found at researchsquare.com.

M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: aotto@mdedge.com.

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